From words to deeds: Health service reform in Poland

After two years of fundamental political changes in Poland a lot of enthusiasm has faded. The country is on its way towards a market economy but the process of transformation is proving more difficult than expected. The social sector in particular is being hampered. Budgetary cuts undermine any feeling of security. Society seems to be entirely unprepared to accept changes that lead to a reduction of social packages offered by former regimes. Hopes associated with 5the outcome of health care reform were aroused by the length of time taken to conceptualize the main proposals. The process started as early as 1980 and was supposed steadily to yield easier access and higher technology. When it became clear that this was unrealistic because of general economic crises, the pace of health service reform was slowed down. It was a painful process to abandon illusion. Now it is becoming accepted that the reform is to improve the elementary effectiveness and efficiency of health services. Thanks to this breakthrough it has been possible to make and put into practice two major decisions: the regional integration of health services, and the new law on health care institutions.